Impact on patients with oral squamous cell carcinoma in different anatomical subsites: a single-center study in Taiwan

The incidence of oral cavity squamous cell carcinoma (OSCC) is particularly high in South Asia. According to the National Comprehensive Cancer Network, OSCC can arise in several subsites. We investigated survival rates and the clinical and pathological characteristics of OSCC in different anatomical subsites in the Taiwanese population. We retrospectively analyzed data for 3010 patients with OSCC treated at the Changhua Christian Hospital. Subsequently, we compared clinical and pathological features of OSCC in different subsites. Pathological T4 stage OSCCs occurred in the alveolar ridge and retromolar trigone in 56.4% and 43.7% of cases, respectively. More than 25% of patients with tongue OSCC and 23.4% of those with retromolar OSCC had lymph node metastasis. The prognosis was worst for hard palate OSCC (hazard ratio 1.848; p < 0.001) and alveolar ridge OSCC (hazard ratio 1.220; p = 0.017). Retromolar OSCC recurred most often and tongue OSCC second most often. The risk for cancer-related mortality was highest for hard palate OSCC, followed by alveolar ridge and retromolar OSCC. We found distinct differences in survival among the different subsites of OSCC. Our findings may also help prompt future investigations of OSCC in different subsites in Taiwanese patients.

The Effect of Suture-Mediated Closure Device on Hemostasis in Patients after Transfemoral Cardiac Procedures - an Evidence-Based Practice

Patients who used manual compression after transfemoral cardiac procedures could suffer from several problems. The suture-mediated closure device may be proven as an effective alternative, offering earlier sheath removal, and potentially a reduction in vascular complications. The aim of this study was to discover empirical bases and clinical application of suture-mediated closure devices on hemostasis in patients after transfemoral cardiac procedures. This study was applied on evidence-based practice in the clinical setting. The search process for evidence-based practices used 3 databases such as MEDLINE, PubMed, and Web of Science, obtaining 14 studies published between 2000 and 2016. The studies selected were assessed by two reviewers for their methodological quality and level of evidence prior to inclusion in the review. Research subjects were patients at the age of ≥ 20 years old who suffered from coronary artery disease and required transfemoral cardiac procedures. This study was implemented in a Medical Intensive Care Unit, Changhua Christian Hospital. The hemostasis status was evaluated based on two categories of, bleeding or not bleeding. Six patients were included in this study. Most of the patients were male with average age of 69.33 ± 11.70 years old. Hypertension, diabetes mellitus, and hyperlipidemia were their common history of diseases. Based on the evaluation outcome, five patients showed hemostasis status and only one patient had bleeding after the compression procedures. This study concludes that the suture-mediated closure device is effective for patients after transfemoral cardiac procedures to reach hemostasis status quickly based on clinical evaluation.

TREATING PEDIATRIC ASTHMA WITH HOLISTIC APPROACHES OF TRADITIONAL CHINESE MEDICINE: A RETROSPECTIVE STUDY

Background: Asthma is a chronic disease increasingly found in children. To find more economical and efficient alternatives to treat pediatric asthma, the Bureau of National Health Insurance of Taiwan launched the Traditional Chinese Medicine Holistic Treatment Program (TCMHTP). The effect of traditional Chinese medicine (TCM) holistic treatments on pediatric asthma was evaluated based on data collected from the program. Materials and Methods: A retrospective study was performed by analyzing a dataset from Changhua Christian Hospital, Taiwan, between January 1st, 2006 and December 31st, 2010. Patients aged between 2 and 15 years, who had been diagnosed with asthma, and had participated in the TCMHTP were recruited, whereas those with other severe diseases were excluded. We analyzed the frequency of emergency department visits (EDV), inpatient admission rate (IAR), and length of hospitalization (LH) of the patients, before and after TCM treatments. Spectral analysis of heart rate variability (HRV) was also conducted. Results: Fifty-eight patients were recruited. The average age of the patients receiving TCM treatments was 5.67±3.03 years. The frequency of EDV decreased from 0.94±0.85 to 0.67±1.19 times annually (p=0.095), the annual IAR decreased from 0.62±0.78 to 0.26±0.67 (p=0.002) and the average LH decreased from 3.32±4.25 to 0.80±1.64 (p=0.000) days per year. Parasympathetically mediated HRV decreased significantly from 60.42±15.33 to 54.89±16.45 nu (p=0.016). Conclusion: The present study revealed that an appropriate period of TCM holistic treatment intervention can not only significantly lower exacerbations and hospitalization frequency but also reduce vagal tone in asthmatic children.

The Relationship between Ischemic Stroke Patients with and without Retroflex Tongue: A Retrospective Study

Background. Patients suffering from stroke exhibit different levels of capability in retroflex tongues, in our clinical observation. This study aims to derive the association of tongue retroflexibility with the degree of severity for stroke patients.Methods. All ischemic stroke patients were collected from August 2010 to July 2013 in the Stroke Center, Changhua Christian Hospital, Taiwan. All participants underwent medical history collection and clinical examination, including tongue images captured by ATDS. Statistical analysis was performed to compare the differences of ischemic stroke patients with and without retroflex tongue.Result. Among the total of 308 cases collected, 123 patients cannot retroflex their tongues, that is, the non-RT group. The length of stay in the non-RT group, 32.0 ± 21.5, was longer than those of the RT counterparts, 25.9 ± 14.4 (pvalue: 0.007). The NIHSS on admission, 14.1 ± 7.8 versus 8.9 ± 5.2, was higher and the Barthel Index upon admission, 18.6 ± 20.7 and 35.0 ± 24.2, was lower for the non-RT patients than that of the RT counterparts. Also, the non-RT patients account for 60.2% and 75.6% for Barthel Index ≤ 17 and NIHSS ≥ 9, respectively.Conclusion. The stroke patients in non-RT group showed significantly poor prognosis and were more serious in the degree of severity and level of autonomy than RT group, indicating that the ability to maneuver tongue retroflex can serve as a simple, reliable, and noninvasive means for the prognosis of ischemic stroke patients.